Mark Lidasan

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

144499 Issued in TX

Practice address

7070 Knights CT Ste 1701
Missouri City, TX 77459-5551

Phone

(346) 595-3735

Fax

(832) 281-1383

NPI assigned

Jan 14, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Convergence Psychiatry PLLC

  • Clinic/Center
  • Missouri City, TX
  • NPI 1417751553
  NPD Authorized official
• Mind & Brain, PC

  • Psychiatry Physician
  • Houston, TX
  • NPI 1073163093
  NPD
• Aslam Loya, M.D. P.a

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1659580728
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1396385662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7070 KNIGHTS CT STE 1701",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774595551",
            "telephone_number": "983-293-3173",
            "fax_number": "832-281-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7070 KNIGHTS CT STE 1701",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774595551",
            "telephone_number": "346-595-3735",
            "fax_number": "832-281-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDASAN",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "144499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lexington Dental Center
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• Wan-Ting Judy Liang, D.D.S.
• Liberty Foster Care, LLC
• Life Essentials Chiropractic, LLC
• Life Fulfilled Inc
• Life Management Centers of Texas LLC
• Lifestages Health and Home Care, LLC
• Lifetime Family Wellness and Weight Loss PLLC

• Psychiatric/Mental Health Nurse Practitioner in Missouri City, TX
• Providers in Missouri City, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.